President Donald Trump declared the opioid crisis a public health emergency on Oct. 26. The declaration was a step back from a promise he made in August to declare the opioid epidemic a national emergency.
The New York Times and other major media outlets have reported that officials at the White House and the Department of Health and Human Services were caught off guard by the August announcement. A public health emergency is a less powerful declaration than a national emergency. However, the declaration still brings resources to the fight against opioid addiction.
“Effective today, my administration is officially declaring the opioid crisis a national public health emergency under federal law,” Trump said at the White House. “I am directing all executive agencies to use every appropriate emergency authority to fight the opioid crisis. This marks a critical step in confronting the extraordinary challenge that we face.”
The opioid crisis in the United States has contributed to a steady rise in overdose deaths for more than a decade. An estimated 52,000 people died from drug overdoses in 2015, according to the most recent Centers for Disease Control and Prevention report on annual overdose deaths. The rate of drug overdose deaths continued to increase during the first nine months of 2016, according to CDC data.
“Families, communities and citizens across our country are currently dealing with the worst drug crisis in American history and even, if you think about it, world history,” Trump said. “This is a worldwide problem. This crisis of drug use, addiction and overdose deaths … has just been so long in the making. Addressing it will require all of our effort, and it requires us to confront the crisis in all of its very real complexity.”
Health advocates have criticized Trump and former President Barack Obama for failing to act more quickly. Trump has also been criticized for backing a variety of overhauls to the health care system that would decrease funding for addiction treatment, but the bills were never approved by Congress.
In a statement provided to DrugRehab.com, the National Center on Addiction and Substance Abuse stated that the president’s declaration had “the potential to free up much-needed federal resources to help prevent and treat opioid addiction and reduce overdose deaths.”
The organization said the declaration was “an important first step towards underscoring the urgency of this problem and encouraging the type of long-term investment our nation needs to solve the addiction crisis. Yet it is not enough. Federal and state leaders must work together to address this epidemic, with the federal government providing states the resources they need to develop an effective response.”
In an interim report on the opioid crisis, a White House commission asked Trump to declare a national emergency. However, the president declared a different kind of emergency known as a public health emergency.
Lexi Reed Holtum, the executive director of the Steve Rummler HOPE Network, said that she was disappointed that Trump didn’t follow through with his August promise. Her nonprofit organization advocates for policies and legislation that improve care for people with chronic pain and addiction.
“Only calling it a public health emergency greatly reduces the amount of resources and funding to address the crisis,” Holtum said. “This means that the public health emergency has to be renewed every 90 days. There’s no new federal funding attached to a public health emergency.”
Trump outlined a variety of measures for combatting opioid misuse and addiction. His strategies included:
Throughout the speech, the president described the impact that the opioid epidemic has had on families and communities. He also referenced his brother Fred Trump Jr.’s struggle with alcoholism. He said he wanted to prevent addiction by discouraging kids from trying alcohol and other drugs.
Many opioid advocates praised Trump’s promises. Holtum said her organization supports several policies that the president presented, including expanding access to treatment for incarcerated individuals, increasing funding for research on nonaddictive painkillers and expecting federal agencies to work together.
“We feel that the president did a fine job of educating individuals in America that are unaware of the opioid crisis with his speech,” Holtum said. “But he did zero to inform us of the mechanics in which he would insist upon to actually fund and create the solutions that we need.”
Dr. Chris Johnson, a board member of Physicians for Responsible Opioid Prescribing, scolded the president’s message because it didn’t mention the pharmaceutical and medical industries’ roles in pushing opioids.
“He said nothing about the perverse business incentives in medicine that cause increased prescribing to move forward without appropriate scientific evidence,” Johnson said. “He said nothing about how these business interests are still acting to expose the American population to opiates in the name of profits.”
Johnson, who heads a Minnesota task force on opioid prescribing protocols, called Trump’s proposal to build a border wall to prevent drug trafficking “nonsense.”
“If he wants to build a wall, he should build one separating the American patient population from doctors who are enthusiastic supporters of Big Pharma and move their products with great efficiency,” Johnson said.
Speaking before the House on Oct. 25, Food and Drug Administration Commissioner Scott Gottlieb said the FDA was planning on issuing guidance to pharmaceutical companies to encourage the development of new therapies to treat drug addiction, according to The Washington Post.
Gottlieb emphasized the importance of access to medication-assisted treatments such as Suboxone (buprenorphine) and Vivitrol (naltrexone). Many people only have access to one of three medications approved by the FDA to treat opioid addiction, and some treatment providers do not provide any MATs.
The FDA has previously faced criticism for approving too many opioids during the 1990s and 2000s. The agency responded to some of that criticism in June by asking the manufacturer of the opioid Opana ER to stop selling the drug after reports of rampant abuse.
Earlier in October, the director of the National Institutes of Health said he’d been tasked with partnering with pharmaceutical companies to create nonaddictive painkillers. Trump emphasized the importance of developing nonaddictive painkillers during his speech on Oct. 26.
“As Americans, we cannot allow this [crisis] to continue,” Trump said. “It is time to liberate our communities from this scourge of drug addiction … We can be the generation that ends the opioid epidemic.”